철 보충제 섭취가 빈혈 여고생의 철 영양상태에 미치는 영향

홍순명,황혜진 대한지역사회영양학회 2001 대한지역사회영양학회지 Vol.6 No.5

This study was designed to investigate the effect of iron supplementation on the iron nutritional status and anemia of high school girls in Korea. One hundred thirty-five female students residing in Ulian metropolitan city in Korea diagnosed as having anemia or iron deficiency participated in this study. One or two tablets of iron medicine(80-160 mg Fe as ferrous sulfate/day) were administered to all participants for 3 months. Subjects were evaluated with a questionaire, measurement of hematological indices before and after iron supplementation. The average height and weight of respondents were 161.62 $\pm$ 4.68 cm and 53.87 $\pm$ 6.10 kg, respectively. Daily intakes of energy were 1597.8 $\pm$ 302.35 kcal(76.0% RDA). Iron intakes were 13.72 $\pm$ 4.17 mg (76.3% of RDA) and calcium intakes were 580.74 $\pm$ 177.21(72.5% of RDA) before iron supp]ementation. At baseline, 63% of all participants had depleted store(serum ferritin 12 ug/ml and/or transferrin saturation(TS) < 14%). After iron supplementation, this proportion declined to 19.3%. 55.6% of subjects had 12 ug/m1 of basal ferritin concentration before iron supplementation, and this proportion declined to 16.3% after iron supplementation. The basal hemoglobin(Hb) concentrations were 12.13 $\pm$ 1.01 g/dl and they increased to 12.79 $\pm$ 0.81 g/dl, which showed significant difference artier iron supplementation(p < 0.001). The basal ferritin and TS(%) were 13.24 $\pm$ 11.66 ng/ml, 18.42 $\pm$ 10.12% and they significantly increased to 32.95 $\pm$ 21.14 ng/ml, 33.53 $\pm$ 16.64%, respectively(p < 0.001). The basal total iron binding protein(TIBC) were 467.81 $\pm$ 97.24 ug/dl and they significantly decreased to 325.05 $\pm$ 48.89 ug/dl(p < 0.001) after iron supplementation. The number of tablets administered was positively correlated with serum iron(t = 0.553, p < 0.01), serum ferritin(t = 0.557, p < 0.01), TS(%)(t = 0.588, p < 0.01) and negatively correlated with TIBC(t= -0.409, p <0.01). The anemia symptoms such as ‘Shortening of breath when going upstairs(p < 0.01)’, ‘Tired out easily(p < 0.01)’, ‘Feeling blue(p < 0.001)’, ‘Decreased ability to concentrate(p < 0.01)’, and ‘Poor memory(p < 0.001)’improved significantly after iron supplementation. In this study, daily iron supplementations were efficacious in improving the iron status and anemic symptoms of female high school students. Regular check-ups and nutrition education for adolescents are necessary because of their vulnerability to iron deficiency. Further studies are needed to determine the minimum effective dose of iron and to examine the adverse effect of long-term iron supplementation.

Effects of Nutritional Education and Iron Supplementation on Iron Nutrition and Anemia of Middle School Girls

Hong, Soon-Myung,Hwang, Hye-Jin The Korean Society of Food Science and Nutrition 2003 Preventive Nutrition and Food Science Vol.8 No.4

The objective of this study was to investigate the effects of iron supplementation and nutrition education on the iron status and anemia of middle school girls in Ulsan city in Korea. The subjects were already diagnosed as having anemia (hemoglobin < 12 g/dL) or iron deficiency (ferritin < 12 ng/mL and/or transferrin sataturation < 14 %). Over a period of three months, one iron tablet (80 mg Fe as ferrous sulfate/day) was administered to the iron deficient subjects and two tablets (160 mg Fe as ferrous sulfate/day) were administered to the anemia subjects. Total calorie intake of subjects was 82.1 % of RDA. The iron intake of subjects was 91.3 % of RDA and the Ca intake was 78.8 % of RDA. The basal hemoglobin concentration of subjects averaged 12.8 1.2 g/dL, and this increased significantly (p < 0.001) to 13.2 0.9 g/dL after iron supplementation. The basal ferritin concentrations were 14.9 14.2 ng/mL and these significantly increased to 26.6 19.8 ng/mL (p < 0.001). The level of total iron binding protein (TIBC) significantly decreased from the initial 523.1 108.7 $\mu\textrm{g}$/dL to 462.2 90.2 $\mu\textrm{g}$/dL (p < 0.001) after iron supplementation. Anemia symptoms such as‘Being bruised easily’, ‘Inflamed inner mouth’, and ‘Pale face’ improved significantly after iron supplementation in the subjects. There was a negative correlation between their class & year ranking and serum iron level, transferrin saturation after nutritional education and iron supplementation. It was shown, therefore, that the higher the improvement of their anemia level after iron supplementation, the higher their academic performance. It was shown that there was some improvement of their dietary attitudes after nutritional education, and that their serum level related to anemia symptoms and iron nutrition was improved after iron supplementation.

액상철분제제 및 시리얼보충이 사회복지시설 아동의 철분영양상태에 미친 영향 비교

정혜경(Chung Hae-Kyung),장영은(Chang Youngeun) 韓國營養學會 2007 Journal of Nutrition and Health Vol.40 No.4

The study was designed to assess the effect of iron and cereal supplementation on children's iron nutritional status in social welfare institutions. Dietary survey was carried out methods of food weighing and record by interview (n = 74). A nutritional intervention study was carried out through supplementing iron supplements and cereal for 4 weeks in 4-12 years old children. Children received daily 40 ㎎ elemental Fe as iron protein succinylate (n = 23) and 3.6 ㎎ elemental Fe as 100 g cereal (n = 24), respectively. Blood samples were drawn before and after supplementation. Nutrients which children's intake was less than two-thirds of the RDA were vitamin A, vitamin B-1, vitamin B-2, calcium and iron. The mean daily intake of iron was 5.1 ㎎ for male and 4.9 ㎎ for female, and 52.3% for male and 45.4% for female of Korean RDA. The proportion of children with iron depletion assessed by TIBC (> 360 ㎍/㎗) and serum ferritin (< 20 ㎍/㎗) were 56.6% and 58.7%, respectively. The proportion of children with the iron deficient erythropoiesis assessed by serum iron (< 70 ㎍/㎗), Hb (< 12 g/㎗), Hct (< 36%) were 76.0%, 58.7%, 64.0%, respectively. After iron supplements treatment, Hb (p<0.001), Hct (p<0.001), serum iron (p<0.001), transferrin saturation (p<0.001) and serum ferritin (p<0.01) increase significantly and only TIBC decreased slightly. After cereal supplementation, in anemic children, Hct (p<0.001), serum iron (p<0.001) and transferrin saturation (p<0.001) were significantly increased. The effect of iron supplements and cereal supplementation in children with iron deficient erythropoiesis were more effective to improve the iron nutritional status than children with iron depletion. It was concluded that cereal supplementation program in anemic children was also effective to improve iron nutritional status. (Korean J Nutr 2007; 40(4): 362~370)

임신부의 철분 보충제 사용과 임신결과

조지현(Ji Hyun Cho),안홍석(Hong Seok Ahn),배현숙(Hyun Sook Bae) 대한지역사회영양학회 2009 대한지역사회영양학회지 Vol.14 No.3

It is known that Korean pregnant women take iron supplements at a higher than the recommended level. This study was designed to provide data on current iron intake levels both from food sources and supplement to better guide iron supplement use during pregnancy. We also explored associations of iron supplement intake levels with various sociocultural factors and pregnancy outcomes. Dietary intakes of 510 pregnant women were assessed by a validated 102-item food frequency questionnaire, and information on types and amounts of nutritional supplement intakes were also attained. While dietary intake levels of most nutrients exceeded the KDRIs (Korea Dietary Reference Intakes: EAR: Estimated Average Requirements), folate fell short of the KDRIs. A total of 428 women (83.9%) reported to take iron supplement. The pregnant women were divided into the three groups (group I: Fe supplement intake≤EAR, group II: EAR<Fe supplement intake≤3 times of EAR, group III: 3 times of EAR<Fe supplement intake). The mean dietary intake of iron was 24% of the total iron intake for pregnant women. Iron intake from food was not significantly different among I, II, and III. In case of iron intake from supplements, the most frequent dose (34.1%) was 90-100 mg/day, and the mean iron supplement intake was 362% of the EAR. The study findings showed that those with higher levels of iron supplements had better meal quality measured by NAR (Nutrient Adequacy Ratio) and INQ (Index of Nutrient Quality). In addition iron supplement intake levels were significantly related to age (20s: 66.5±38.6 mg/day, 30s: 77.3±47.8 mg/day, p<0.0116) and experience of childbirth (1st pregnancy: 70.9±41.2 mg/day, 2nd pregnancy: 64.5±39.5 mg/day, ≥3rd pregnancy: 94.4±63.8 mg/day, p<0.005). However, no significant difference was found between iron supplement intake levels and various pregnancy outcomes including birth weight, birth height, gestational age, weight gain during pregnancy, and jaundice. It is worrisome that iron intake by supplement use greatly exceeded the EAR, suggesting the need of appropriate guidelines for iron supplement intake during pregnancy. Thus iron overdose from supplements in pregnancy should be considered as a serious condition. (Korean J Community Nutrition 14(3):327~339, 2009)

Effectiveness of iron supplementation in the perioperative management of total knee arthroplasty: a systematic review

( Seung Hoon Lee ),( Joong Il Kim ),( Wonchul Choi ),( Tae Woo Kim ),( Yong Seuk Lee ) 대한슬관절학회 2020 대한슬관절학회지 Vol.32 No.-

Introduction/purpose: The purpose of this systematic review was to evaluate the effect of iron supplementation during total knee arthroplasty (TKA): (1) Is the iron supplementation necessary during TKA? (2) When is the optimal timing of iron supplementation? (3) Which is better, between orally and intravenously administered iron supplementation? And (4) What is the optimal dose of iron supplementation? Materials and methods: A rigorous and systematic approach was used and each of the selected studies was evaluated for methodological quality. Data about study design, total number of cases enrolled, iron administration method, timing, and dose were extracted. Change in hemoglobin and transfusion rates were extracted to evaluate the effectiveness of iron supplementation. Results: Eleven studies were included in the final analysis. Most of studies reported that hemoglobin change between iron and control group did not show any difference. Only one study reported that iron supplementation could reduce the decrease in hemoglobin. However, transfusion rate showed a decrease in the iron supplementation group compared with the control group. There was no clear consensus on the optimum timing and dose of iron supplementation and intravenously administered iron was more effective than orally administered iron, especially in anemic patients. Conclusion: Iron supplementation is not clear as a way to raise hemoglobin levels after TKA, but an effective treatment for lowering transfusion rate, especially in patients with anemia. We could not determine the optimal timing and dose of the iron. Intravenously administered iron was similar to, or better than, orally administered iron for improving hemoglobin levels and transfusion rate.

Effectiveness of iron supplementation in the perioperative management of total knee arthroplasty: a systematic review

Lee Seung Hoon,김중일,Choi Wonchul,Kim Tae Woo,이용석 대한슬관절학회 2020 대한슬관절학회지 Vol.32 No.-

Introduction/purpose: The purpose of this systematic review was to evaluate the effect of iron supplementation during total knee arthroplasty (TKA): (1) Is the iron supplementation necessary during TKA? (2) When is the optimal timing of iron supplementation? (3) Which is better, between orally and intravenously administered iron supplementation? And (4) What is the optimal dose of iron supplementation? Materials and methods: A rigorous and systematic approach was used and each of the selected studies was evaluated for methodological quality. Data about study design, total number of cases enrolled, iron administration method, timing, and dose were extracted. Change in hemoglobin and transfusion rates were extracted to evaluate the effectiveness of iron supplementation. Results: Eleven studies were included in the final analysis. Most of studies reported that hemoglobin change between iron and control group did not show any difference. Only one study reported that iron supplementation could reduce the decrease in hemoglobin. However, transfusion rate showed a decrease in the iron supplementation group compared with the control group. There was no clear consensus on the optimum timing and dose of iron supplementation and intravenously administered iron was more effective than orally administered iron, especially in anemic patients. Conclusion: Iron supplementation is not clear as a way to raise hemoglobin levels after TKA, but an effective treatment for lowering transfusion rate, especially in patients with anemia. We could not determine the optimal timing and dose of the iron. Intravenously administered iron was similar to, or better than, orally administered iron for improving hemoglobin levels and transfusion rate.

운동영양학 : 철분 투여가 여자 검도 수련생의 혈중 철분 지표와 지질 및 항산화능에 미치는 영향

김종호(JongHoKim) 한국체육학회 2005 한국체육학회지 Vol.44 No.6

Elevated iron stores may or may not promote atherogenesis by increasing free radical formation and oxidative stress, but studies about effects of iron supplementation on serum lipid profile and antioxidant capacity are lacking. We investigated changes in iron status, serum lipid profile and antioxidant capacity of Kumdo trainees after iron supplementation for 6 weeks. Twenty iron-depleted (serum ferritin < 20 g/L), nonanemic (hemoglobin > 11 g/dL) women who had participated in Kumdo received iron (iron group) or placebo (placebo group) for 6 wk in a randomized, double-blind trial (n = 10 per group). No significant differences between the groups in baseline iron status, nutrition status and physical activities were observed. After treatment, serum iron and transferrin saturation increased significantly in the iron group (P < .01 and P < .05, respectively). Serum transferrin receptor concentrations increased significantly in the placebo group (P < .05) but not in the iron group. No significant differences between the groups in lipid profiles, except for Serum HDL-C level which decreased significantly in the iron group (P < .05) were observed. TBARS decreased significantly in the iron group (P < .05)

철분과 셀레늄의 섭취수준이 흰쥐의 망간 이용에 미치는 영향

전예숙,최미경 동아시아식생활학회 1997 동아시아식생활학회지 Vol.7 No.2

The purpose of this study was to investigate the effect of iron and selenium intakes on utilization of manganese in rats fed adequate, 2-fold, 4-fold iron and adequate, high selenium for 6 weeks. There was no difference feed intake across iron and selenium containing diet groups. Body weight gain in 2-fold iron and high selenium group(MFeHSe) was significantly higher than those in other groups. Serum iron level was increased with iron increment, and liver iron content was decreased with selenium supplementation. Selenium and manganese contents in tissues were decreased with iron increment. In the case of manganese balance, manganese excretion through feces was significantly increased as iron intake was increased. However, retention and apparent absorption of manganese were not significantly affected by dietary iron. From these results, it could be suggested that the supplementations of iron and selenium affected the manganese utilization. Therefore, it must be considered interaction with various minerals in micro-nutrient supplementations.

Clinical Study on the Iron Absorption from Heme-Iron Polypeptide and Nonheme-Iron

Nam, Tae-Sik,Shim, Ji-Yeon,Kim, Byung-Ju,Rah, So-Young,Park, Kwang-Hyun,Kim, Seon-Young,Mun, Eun-Gyeng,Jeong, Young-Ju,Han, Myung-Kwan,Cha, Youn-Soo,Chae, Soo-Wan,Im, Mie-Jae,Kim, Uh-Hyun The Korean Nutrition Society 2006 Nutritional Sciences Vol.9 No.4

Iron bound to heme appears to be more bioavailable than iron salts. A clinical study was performed to investigate the absorption efficiency of heme-iron and iron-salt products available. Heme-iron and nonheme-iron supplements have become available in Korea. We performed iron absorption studies to compare the absorption of heme-iron polypeptide (HIP) products made from digested hemoglobin, produced in Korea (HIPk) and imported from Japan (HIj), with that of iron salts. In the study, 80 subjects were divided into 5 groups (n=56): placebo group; 12 mg glucose, HIPk group; 12 mg iron as HIPk, HIj group; 12 mg iron as HIj, iron-salt group 1; 12 mg of iron as ferrous aminoacetate, and iron-salt group 2; 100 mg iron as ferrous aminoacetate. Changes in serum iron levels were measured at 3 and 5 hours post ingestion. Absorption of iron in HIPk was higher compared to HIj, iron-salt or placebo. There was a significant inverse correlation between low serum iron levels $(<80{\mu}g/dl)$ and iron absorption from HIPk. These results demonstrated that HIPk was more bioavailable, even taken with a meal, and would have potential advantages over iron salt or HIj as an iron supplement. Our results indicate that heme-iron absorption is regulated by iron status through a heme receptor, whereas iron-salt absorption is unregulated.

Clinical Study on the Iron Absorption from Heme-Iron Polypeptide and Nonheme-Iron

Tae-Sik Nam,Ji Yeon Shim,Byung-Ju Kim,So Young Rah,Kwang-Hyun Park,Seon-Young Kim,Eun-Gyeong Mun,Young-Ju Jeong,Myung-Kwan Han,Youn-Soo Cha,Soo-Wan Chae,Mie-Jae Im,Uh-Hyun Kim 한국영양학회 2006 Nutritional Sciences Vol.9 No.4

Iron bound to heme appears to be more bioavailable than iron salts. A clinical study was performed to investigate the absorption efficiency of heme-iron and iron-salt products available. Heme-iron and nonheme-iron supplements have become available in Korea. We performed iron absorption studies to compare the absorption of heme-iron polypeptide (HIP) products made from digested hemoglobin, produced in Korea (HIPk) and imported from Japan (HIj), with that of iron salts. In the study, 80 subjects were divided into 5 groups (n=56): placebo group; 12 ㎎ glucose, HIPk group; 12 ㎎ iron as HIPk, HIj group; 12 ㎎ iron as HIj, iron-salt group 1; 12 ㎎ of iron as ferrous aminoacetate, and iron-salt group 2; 100 ㎎ iron as ferrous aminoacetate. Changes in serum iron levels were measured at 3 and 5 hours post ingestion. Absorption of iron in HIPk was higher compared to HIj, iron-salt or placebo. There was a significant inverse correlation between low serum iron levels (<80 ㎍/㎗) and iron absorption from HIPk. These results demonstrated that HIPk was more bioavailable, even taken with a meal, and would have potential advantages over iron salt or Hlj as an iron supplement Our results indicate that heme-iron absorption is regulated by iron status through a heme receptor, whereas iron-salt absorption is unregulated.